子母钢板法治疗复杂胫骨平台骨折临床分析

Primary and Secondary-Plate Method for Complex Tibia Plateau Fractures

目的探讨子母钢板法治疗复杂胫骨平台骨折的临床疗效。方法 2004年3月至2007年12月我院采用手术复位、自体骨移植植骨和子母钢板固定治疗复杂胫骨平台骨折45例,其中男34例,女11例;年龄19～59岁,平均37.5岁。其中,交通事故伤37例,高处坠落伤5例,其他3例。胫骨平台骨折Schatzker型32例、型13例。结果随访14～26个月,1例骨折不愈合,1例感染,膝关节功能Rasmussen评分,优36例,良3例,中3例,差3例。44例患者骨折愈合完全负重行走后患膝与健膝的胫骨平台后倾角、关节面塌陷程度、胫骨平台最大横经的X线片测量值比较无差异。结论子母钢板法治疗复杂胫骨平台骨折对关节周围软组织损伤小,可最大程度解剖复位关节并坚强内固定,利于早期进行关节功能锻炼,降低并发症,是治疗复杂胫骨平台骨折安全有效的方法。

Objective To investigate the clinical result of primary and secondary-plate method for treatment of complex tibial plateau fractures. Methods 45 patients with Schatzker classification of Ⅴ ,Ⅵ type complex tibial plateau fractures were treated with primary and secondary-plate fixation. Results follow-up of 14-26 months,one cases of fracture nonunion, 1 case of infection,Rasmussen Knee Function Assessment ：excellent 36 eases,good 3 cas- es, fair 3case and poor 1 case ; There is no difference in compare with the tibia plateau angle, the degree of articular surface collapse and the largest diameter through the tibia plateau of X-ray examination between the normal and the injured knee of 44 cases who could walk with full weight bearing after fracture healing. Conclusion It can minimize soft tissue injury and optimize anatomic reduction and firm fixation that the primary and secondary-plate method for treatment of complex tibia plateau fracture, it also contribute to early stage joint functional exercise and reduce com- plications and is an alternative safer and more effective method.